How to handle your child’s peanut allergy
By Anna Sharratt, BrighterLife.ca
Janie Park’s son William was a year old when his life with a peanut allergy officially began. The family had just enjoyed a falafel lunch at a Middle Eastern restaurant when William, who’s now three, began developing red splotches around his mouth. Minutes later he seemed asleep in his stroller. It was only after Park transferred him to his crib that warning bells went off.
“He was crying weirdly, so I went in to his room,” she remembers. “He had hives everywhere and his mouth was swollen, his face was swollen. I was totally freaked out.”
When Park rushed her son to the local hospital, she was expedited through the emergency ward. “The receptionist looked at him and said: ‘Go right now,’” Park says.
Later, after giving William a dose of oral antihistamine to combat the allergic reaction, a doctor told Park he suspected her son had eaten a trace amount of peanuts. He prescribed an EpiPen, a one-shot, life-saving dose of epinephrine, a hormone that can open a closed airway during the severe allergic reaction called anaphylaxis.
Now, two years later, Park is ever-vigilant. She has warned William’s preschool of his allergy and shown all the caregivers there how to use an EpiPen. The preschool has been made a peanut-free zone. And before every play date, Park reminds other parents of her son’s allergy.
Now that William has turned three, an appointment with the allergist is scheduled to determine how severe his allergy is. “I’m hoping to hear he’ll just grow out of it,” Park says.
Peanut allergy is common
In Canada, up to 1.5% of children are allergic to peanuts, according to the Allergy/Asthma Information Association.
That means as many as 15 kids out of every 1,000 have to stay away from peanuts or they’ll experience symptoms ranging from hives, facial swelling, nausea, vomiting and diarrhea, to a sharp drop in blood pressure (turning white or fainting), swelling of the airways causing trouble breathing, an inability to speak and unconsciousness. If the airway shuts completely, they could die within an hour, or even within a few seconds, says Monika Gibson, regional coordinator for Ontario of the Allergy/Asthma Information Association.
“The most important thing we stress is give the EpiPen as soon as possible,” she says. “The EpiPen freezes the reaction at the point it’s at. If you wait until [the child] is unconscious, you may not get them back.”
And don’t worry about administering epinephrine unnecessarily. “If it turns out the individual was not suffering an anaphylactic reaction, you may have a more hyper person,” says Gibson. No harm done.
Preventing peanut exposure
For now, there is no cure for peanut allergy. “There is a lot of very interesting research at the clinical level,” says Stuart Carr, president of the Canadian Society of Allergy and Clinical Immunology. “We may have some treatment options imminently.” These include oral food desensitization, a form of immunotherapy in which an individual is given gradually larger amounts of an allergen until no allergic response is shown, and which must always be conducted by a health care professional in a controlled environment.
But, he acknowledges, “there aren’t really many treatment options now for patients walking into the clinic today.” For that reason, prevention is your best line of defence:
- Choose products labeled peanut-free.
- Know your ingredients – peanuts can be listed under a variety of names. Forgo products that “may contain peanuts” and skip items with peanuts by another name: peanut oil, beer nuts, ground nuts, mandelonas, goober nuts, valencias, etc.
- When dining in restaurants, ask your server about the ingredients in a given dish. Gibson recalls an individual who had a reaction to lasagna that had been thickened with peanut butter.
- Bring food you have prepared at home to your child’s school, play date and party.
- Don’t give a caregiver or teacher a list of items that are safe for your child to eat, advises Gibson. That’s because while individually wrapped products may be peanut-free, they may be contaminated when bought in bulk. For example, chocolate buds may be safe in their packaging, but may come in contact with peanuts if in an open bin in a health food or bulk food store.
- Teach caregivers and teachers how to use an EpiPen. On the first day of preschool, Park showed every caregiver how to use the device and had each sign a form acknowledging this training.
- Have your child carry an EpiPen at all times, and carry additional units when travelling. “Mom and dad should both have one,” recommends Gibson.
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At 52 years of age I’ve lived with my peanut allergy for nearly the same amount of time. My advice to parents is to be vigilant, be prepared, but don’t lose sight of the need for children to live their lives as normally as possible.
I grew up in an age where allergies were uncommon and misunderstood. At birthday parties well-meaning mothers would ply me with their homemade peanut cookies, “It’s alright, just have one.”.Today, parents, schools, restaurants, and manufacturers are more aware than ever. You have legal liability issues to thank for the manufacturers’ move to peanut free environments and those that include the ‘May contain nuts” on their packaging. However, not that I’m advocating taking unnecessary risks with your child’s welfare, I personally take the warnings on the labels with a grain of salt. In my opinion, it’s the legal liability issue they’re most often addressing rather than any real chance there were nuts mistakenly inserted in the product or that it’s come into contact with nuts.
Even as an adult I’ve had encounters both my fault and accidental. I don’t take chances by going to a Thai restaurant but, was caught unawares once in American style restaurant and ordered an oriental salad that turns out had peanut oil in the dressing it even though it wasn’t stated in the menu description. I carry an epipen at all times. Well, almost always.
So, I wish I had some sage advice for you. I don’t. Just be sure to find ways to make your children aware without causing so much fear they can’t be children. They’ll grow up soon enough. Good luck.
Both my children (boys aged 11 and 9) have peanut allergies. Growing up, I had a best friend who had a peanut allergy and I saw my share of anaphylactic reactions since there was very little awareness of this type of allergy. Having had that experience under my belt, my husband and I take the allergy seriously and do what we can to protect our kids. We don’t, however, let it rule our lives or our activities. We have taught the boys to read labels themselves and that the label should be checked every time (even for products that they have had in the past with no incident). When in doubt, they know to check with an adult.
Both boys carry epi-pens in a pouch around their waist everywhere they go. We actively teach people in our community how to use the pens, even our babysitters. We have never had to administer the pen, but better to be safe than sorry. When we go away, we also carry Benedryl with us.
Both boys also carry hand sanitizer in their backpacks to school and camp. My 11-year old is quite adamant that he clean his hands before eating just in case his hands touched something that was contaminated. This is probably just good practice regardless of the allergy!
The most difficult situations for us is when we are at a restaurant. Things are much better today than they were even just a couple of years ago, but there is still high risk of cross contamination. My best is advice is just to talk to the restaurant manager, understand their allergy policy, understand what goes into the fyers (especially if the kids eat fries), and then use your judgement.
As I understand from our allergist, the allergy can become less severe over time, but only if there is little or no exposure to the protein that causes the allergic reaction. We are hopeful that they may outgrow it. As they move into the pre-teen and teen years, we know we won’t be able to control everything that they eat. We can only hope that the foundation we have built will carry forward throughout their lives.
It’s really about education and vigilence, but at the same time, letting your child be a child and not always fearful and anxious. My youngest child has an anaphylactic allergy to sesame seeds discovered at 6 months of age (hummus containing tahini). Sesame seeds, you say? Unheard of, right? Believe it or not it is listed as one of the top allergens in Canada and is required to be declared on labels in Canada (thank goodness!). He is also mildly allergic to soy and fish. We’ve been lucky that friends and caregivers have been very sensitive and careful with his allergy. Caregivers have been trained reading labels as well as on epi-pen use.
School will be a challenge. Schools are peanut free, but they are not sesame free and I can’t expect that they will be. However, I will work very diligently with the staff at the school to raise awareness, and my son will carry an epi-pen wherever he goes.
Restaurants can be tricky, but we do have our favourites where we know he is safe and we have talked to staff about the allergies.
Consider complimentary and alternative care to try and help your child heal. Although this is never guaranteed, it does not hurt to talk to alternative care providers such as holistic nutritionists, naturopaths, and homeopaths who may be helpful in your journey. I would never advocate steering clear of doctors – our approach includes our family doctor, our allergist, a homepath, and a wholistic nutritionist, and I’m convinced this approach has helped in reducing the severity of the allergies, as he has outgrown allergies/sensitivies to eggs, dairy, and wheat.
Great article and it is true that we are lucky today that there is such great awareness to peanut allergies. Practical tips here to help parents.
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